Educational Outreach Impact Study
Help us assess the effectiveness and reach of our educational outreach activities.
Participant Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Affiliation or Organization
Which educational outreach activity did you participate in?
*
Please Select
Workshop
Seminar
Webinar
School Visit
Community Event
Other
Date of the outreach activity
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
How would you rate the overall impact of the outreach activity?
*
1
2
3
4
5
What knowledge or skills did you gain from this activity?
*
Do you have any suggestions for improving our educational outreach efforts?
Submit Study Feedback
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